PROJECT SUMMARY In this application we propose to continue our highly successful multidisciplinary post-doctoral training program in critical care outcomes research. The training program provides 2-3 years of research training in the areas of critical illness and acute organ dysfunction, with a focus on complex critical illness syndromes such as acute lung injury and sepsis. The academic home of our training program is the CRISMA Center, an interdisciplinary research center with over 30 extramurally funded faculty members, 40 research staff members, and multiple core facilities for administrative support, laboratory work, and data management. CRISMA post-doctoral scholars will train in one of five interrelated areas based on CRISMA?s five scientific programs: (a) immunobiology and the cellular basis for organ injury; (b) systems modelling and computational biology; (c) clinical epidemiology of critical illness; (d) critical care ethics and decision making; and (e) critical care organization and management. In this renewal application we have further strengthened our training program by expanding training opportunities in precision medicine, predictive analytics, implementation science, and decision science. Trainees partner with their principle trainer and their training group to develop structured, written career development plans. Training activities include intensive mentorship in the form of weekly meetings with primary mentors and monthly meetings with their mentorship teams; didactic education in the form of formal coursework in research methodology through the University of Pittsburgh Institute for Clinical Research Education, in most cases culminating in the attainment of a master?s degree; and experiential research in which trainees design, execute, and complete mentored research projects in their chosen area of study. In addition, trainees present and receive feedback on their ongoing work through participation in weekly research seminars; as well as receive interactive instruction in the responsible conduct of research in both formal and informal settings. The training environment is supported by numerous training and career development resources at the University of Pittsburgh, including tight integration with our University?s Clinical and Translational Research Institute. Overall, our training program is designed to create an innovative scientific workforce with the skills necessary to answer the most pressing research questions in the field of critical illness and acute cardiopulmonary disease.